Primary Standard Plan
Monthly Premiums
The rates below are for Individuals under the age of 60, per insured per month.
If you are a member as part of a Group/ Company, your rate may be different.
Principal
R490 PM
Adult Dependent
R470 PM
Child Dependent
R205 PM
The rates below are for Individuals over the age of 60, per insured per month.
Principal
R685 PM
Adult Dependent
R660 PM
| Benefits |
|---|
|
In-Hospital Accident Benefit |
|
ICU Benefit |
|
Post-Hospital Accident Rehabilitation |
|
In-Hospital Illness Benefit |
|
Maternity Benefit |
|
casualty benefit for accidents |
|
casualty benefit for illness |
|
general practitioner visits (GP/doctor) |
|
out-of-network general practitioner visits (gp) |
|
in-room procedures |
|
pharmacy clinic nurse care |
|
specialist benefit |
|
acute medication |
|
over-the-counter medication (OTC) |
|
chronic medication |
|
radiology |
|
pathology |
|
dentistry |
|
optometry |
| DESCRIPTIONS |
|---|
|
No Benefit. |
|
No Benefit. |
|
No Benefit. |
|
No Benefit. |
|
No Benefit. |
|
R2 500 per policy per annum. Pre-authorisation required. |
|
R2 500 per policy per annum for after-hours treatment only. Pre-authorisation required. |
|
Managed unlimited GP consultations at a network doctor. Pre-authorisation required for every GP visit from the 5th consultation onwards. |
|
2 consultations refunded at R475 per visit. |
|
Defined list of procedures a network GP can perform in their rooms at no additional charge. |
|
Unlimited care for a defined list of procedures available from nurses at Network pharmacies with contracted clinics. |
|
R2 600 per insured, per annum. Referral by network GP required. Insured must pay cash and claim from GENRIC Health. Subject to GENRIC Health Protocols and Limits |
|
Unlimited Acute Medication available only from a Network pharmacies. Subject to Formulary. |
|
R210 per policy per month. R850 per policy per year. Subject to Formulary. |
|
Unlimited Chronic Medication for diseases on our CDL. All Chronic Medication needs to be approved by us. Chronic Medication may be obtained from a Network pharmacy or from a Network Dispensing Doctor. Subject to Formulary and to a maximum price based on the average price of generic drug in that category. If your medicine costs more, you will have to pay the additional amount. |
|
Unlimited Black and white x-rays only. Insured must be referred by a network GP. |
|
Unlimited blood tests according to our list of tests. Insured must be referred by a network GP. |
|
Basic dentistry only. Treatment available based on GENRIC Health’s Protocols and limits. |
|
Only available at Specsavers branches. 1 consultation, 1 set of frames with single vision lenses per insured, every 24 months. Maximum of R1 450. |
ADDITIONAL BENEFITS
Hospital Footprint
Access to all private hospitals accepting health insurance products. Pre-Authorisation is required for all hospital admissions on 010 599 1172.
VALUE ADDED BENEFITS
24-hour Emergency Medical Services
No Benefit.
Client Assistance Programme Benefits
Personal Health Advisor – Clinically trained Personal Health Advisor available for telephonic consultations and advice 24/7.
Credit and Debt Assist – a full range of debt management and financial planning services.
Legal Assist – telephonic legal advice from qualified attorneys.
Trauma Counselling – Trauma debriefing by a qualified nurses who are, where necessary able to refer the insured to the next level of counselling.
Accidental Death
Benefit
Principal: R15 000
Adult Dependant: R10 000
Child Dependant: R8 000
PHARMACY CLINIC NURSE-BASED CARE
Nurse-Based Care
Care from qualified nurses at over 700 pharmacy Wellness Clinics. Visit them in store at your convenience or book an appointment for a consultation. Nurses will give you a medical referral if necessary.
Available at all contracted Network Pharmacies, including Dischem Clicks, Medirite etc.
Pre-authorisation is required after 10th visit.
General Member Wellness
- Glucose and Cholesterol screening / testing / monitoring.
- Treatment of wounds.
- Administration of injections, including annual flu injection.
- Hb, Malaria and Urine Screening.
- Syringing of ears.
- Advice on how to best manage your status and health.
Women's Health
Caring advice women can rely on, offering all types of female health assessments such as pregnancy testing, breast screening, pap smear testing and other female screenings.
Assistance Managing Chronic Conditions
Nurses will help you manage your chronic condition and assist you with monitoring and
advice, including but not limited to:
• Diabetes Hba1C and foot screening.
• Blood pressure and lipogram testing, BMI monitoring.
• Peak flow and nebulization. Control asthma by getting rescue medication directly into the lungs.
• HIV screening, testing and counselling: Learn your HIV status and get psychological help after testing positive. A counselling session is offered pre-testing as well.
